We evaluated an effect of the distance between the incision line and corneal limbus on surgically induced astigmatism in sutureless cataract surgery with scleral tunnel incision. We made a 6mm scleral tunnel incision 1.0mm from the limbus (Group 1, 24 eyes) and 2.5mm from the limbus (Group 2, 30 eyes) and implanted polymethylmethacrylate (PMMA) intraocular lenses with a round optic of 6mm following phacoemulsification. We employed the Jaffe method and Cravy method of vector analysis to evaluate the change of Surgically induced astigmatism. The mean surgically induced astigmatism using Jaffe method was 1.24 D and 0.98 D one day after surgery in Group 1 and 2, respectively. The difference between them was statistically significant(p<0.01) and became insignificant(p>0.05) after postoperative one week. In the superior incision cases, the difference using Cravy method was not statistically significant for whole followup period. In the temporal incision cases, the surgically induced astigmatism was 0.39 D and 0.02 D one day after surgery in Group 1 and 2, respectively. The difference was statistically significant(p<0.05) and became statistically insignificant(p>0.05) after postoperative one week. In this study it was found that a distance of incision line from corneal limbus longer than 1 mm was not an important factor in influencing the surgically induced astigmatism one week after sutureless cataract surgery using a watertight scleral tunnel incision.
Astigmatism ; Cataract* ; Follow-Up Studies ; Lenses, Intraocular ; Limbus Corneae ; Phacoemulsification ; Polymethyl Methacrylate

To evaluate the changes of surgically induced astigmatism in sutureless small incision cataract surgeries, we divided our cases into two groups. In group 1 (38 eyes), we performed phacoemulsification and implanted foldable silicone intraocular lenses (IOLs) through 3.2mm clear corneal incisions. In group 2 (30 eyes), we did phacoemulsification and implanted PMMA IOLs through 5.1mm scleral tunnel incisions. We analyzed the early postoperative astigmatism in two groups. The average surgically induced astigmatism in group 1 was 0.1D at one day, 0.36D at six months. In group 2, it was 0.6D at one day, and 0.36D six months after surgery. There was no statistically significant difference between the two groups(p>0.05). In the superior incision cases, the average surgically induced astigmatism in group 1 was 0.47D against the rule(-0.47D) at one day, -0.07D at six months. In group 2, it was 0.42D at one day, 0.44D six months after surgery. There was no statistically significant difference between the two groups(p>0.05). In the temporal incision cases, the mean surgically induced astigmatism in group 1 was 0.31D at one day, 0.59D at six months. In group 2, it was 0.83D at one day, 0.24D six months postoperatively. Also, there was no statistically significant difference between the two groups(p>0.05). Percentages of uncorrected visual acuity above 0.5 reached over 90% in group 1 at one month postoperatively, and in group 2 at two months postoperatively. In conclusion, both the 3.2mm clear corneal incision group and the 5.1mm scleral tunnel incision group revealed good visual rehabilitation in early postoperative period and their mean surgically induced astigmatism was not statistically significant.
Astigmatism* ; Cataract* ; Lenses, Intraocular ; Phacoemulsification ; Polymethyl Methacrylate ; Postoperative Period ; Rehabilitation ; Silicones ; Visual Acuity

Background/Aims: The pathophysiology of functional abdominal bloating and distention (FABD) is unclear yet. Our aim is to compare the diversity and composition of fecal microbiota in patients with FABD and healthy individuals, and to evaluate the relationship between small intestinal bacterial overgrowth (SIBO) and dysbiosis. Methods: The microbiota of fecal samples was analyzed from 33 subjects, including 12 healthy controls and 21 patients with FABD diagnosed by the Rome IV criteria. FABD patients underwent a hydrogen breath test. Fecal microbiota composition was determined by 16S ribosomal RNA amplification and sequencing. Results: Overall fecal microbiota composition of the FABD group differed from that of the control group. Microbial diversity was significantly lower in the FABD group than in the control group. Significantly higher proportion of Proteobacteria and significantly lower proportion of Actinobacteria were observed in FABD patients, compared with healthy controls. Compared with healthy controls, significantly higher proportion of Faecalibacterium in FABD patients and significantly higher proportion of Prevotella and Faecalibacterium in SIBO (+) patients with FABD were found. Faecalibacterium prausnitzii, was significantly more abundant, but Bacteroides uniformis and Bifidobacterium adolescentis were significantly less abundant in patients with FABD, compared with healthy controls. Significantly more abundant Prevotella copri and F. prausnitzii, and significantly less abundant B. uniformis and B. adolescentis were observed in SIBO (+) patients, compared with healthy controls. Conclusion The fecal microbiota profiles in FABD patients are different from those in healthy controls, particularly in SIBO (+) patients, suggesting a role of gut microbiota in the pathogenesis of FABD.

No abstract available.
Intervertebral Disc*

Background/Aims: Low baseline impedance levels (BILs) have been suggested to be evidence of GERD. The aim of this study is to investigate the usefulness of esophageal BILs for the diagnosis of nonerosive reflux disease (NERD) and the proper time for measurement in endoscopy-negative Korean patients with esophageal or supraesophageal symptoms. Methods: Endoscopy-negative patients with esophageal or supraesophageal symptoms who underwent esophageal multichannel intraluminal impedance-pH monitoring were included. BILs were measured in the proximal and distal esophagus around 10 minutes before meals, 10 minutes and 30 minutes after meals, 30 minutes before the start of nighttime sleep, and 30 minutes and 60 minutes after the start of nighttime sleep. Results: A total of 104 patients were included in the study. Distal and proximal esophageal BILs were decreased after meal ingestion. The BILs of the distal esophagus were significantly lower at all time points in the NERD group, but not in the reflux hypersensitivity (RH) group, compared with the functional group. The area under the receiver operating characteristic curve for the diagnosis of NERD was significant at all time points, but that for the diagnosis of RH was not. The cut-off value of 2375 Ω or 2125 Ω measured around 30 minutes before or 60 minutes after the start of nighttime sleep, respectively, were appropriate for the diagnosis of NERD. Conclusion The BILs of the distal esophagus measured at time points before or after the start of nighttime sleep appear to be useful for the diagnosis of NERD, but not for the diagnosis of RH, in endoscopy-negative Korean patients with esophageal or supraesophageal symptoms.

PURPOSE: To evaluate the histological changes of the synovial membrane treated by 166Ho-Chitosan complex in collagenase induced arthritis of the knee in the rabbit. MATERIAL AND METHOD: Arthritis was induced in sixteen rabbits by intra-articular injection of 1mg collagenase II and then treated by intra-articular injection of 0.4mCi 166Ho-Chitosan complex 2weeks later. The radioisotope scan was checked in each rabbit for the distribution and extra-articular leakage of the 166Ho-Chitosan complex. The synovial tissues from the femorotibial joints were evaluated for serial histological changes 2, 4, 8, 12 weeks after the 166Ho-Chitosan complex injetion. RESULTS: Two weeks after 166Ho-Chitosan complex administration, inflammatory cells such as giant cells, lymphocytes, histiocyte, and fibroblasts appeared in the subsynovial stroma. The most synovial cells were necrotized. Four weeks after 166Ho-Chitosan complex administration, the inflammatory cells were decreased and many fibroblasts appeared on the subsynovial stroma. There was neovasculization in the synovial membrane 4 weeks after administration. The fibers of collagen were noticed in the synovial membrane and subsynovial stroma at 8 weeks. There was no synoviocyte in the synovium and the thickness of fibrosis was increased at 12weeks. There were fragmentation of the nucleoli of synoviocyte and endothelial cell on the transmission electron microscope (TEM) . CONCLUSION: This study suggests that the synovial membranes treated by 166Ho-Chitosan complex in the collagenase induced arthritis of the knee in the rabbit show early radiation damage and then subsequently develop the fibrosis, and no synovial cell regeneration was observed until 12 weeks.
Arthritis* ; Collagen ; Collagenases* ; Endothelial Cells ; Fibroblasts ; Fibrosis ; Giant Cells ; Histiocytes ; Injections, Intra-Articular ; Joints ; Knee* ; Lymphocytes ; Rabbits ; Regeneration ; Synovial Membrane

BACKGROUND/AIMS: Probiotics are expected to modify the composition of gut microbiota. We aimed to investigate the changes in the composition and diversity of gut microbiota by the administration of probiotics in healthy individuals. METHODS: Twelve healthy volunteers with age range of 30–42 years provided baseline fecal samples. Subsequently, they took commercially available probiotic capsules (a mixture for Bifidobacterium, Lactobacillus, and Enterococcus) for 4 weeks. Fecal samples were collected at 4 weeks of administration and 2 weeks after the stop of administration. Fecal microbiota was analyzed via 16S ribosomal RNA gene sequencing. RESULTS: The mean Shannon index was not significantly altered by the 4-week administration of probiotics (4.365 vs 4.556, P > 0.05). The proportion of Bacteroidetes, Actinobacteria, Firmicutes, and Proteobacteria was not significantly changed by the 4-week administration of probiotics. At the genus level, the proportions of Lactobacillus (2.138% vs 2.773%, P = 0.028) and Enterococcus (0.022% vs 2.758%, P = 0.004) significantly increased 4 weeks after the administration of probiotics, but reduced 2 weeks after the stop of administration (2.773% vs 3.292%, P = 0.064 and 2.758% vs 0.001%, P = 0.001). CONCLUSIONS: The diversity of fecal microbiota is not significantly affected by 4 weeks of probiotics administration. The proportion of fecal microbiota at the genus level is significantly altered by the administration of probiotics. However, this effect does not seem to last long, probably because of homeostasis or dietary influence.
Actinobacteria ; Bacteroidetes ; Bifidobacterium ; Capsules ; Enterococcus ; Firmicutes ; Gastrointestinal Microbiome ; Healthy Volunteers ; Homeostasis ; Lactobacillus ; Microbiota ; Probiotics ; Proteobacteria ; RNA, Ribosomal, 16S

BACKGROUNDS: As Korea has advanced into the aging society, Acute Coronary Syndrome is increased in number, especially elderly age group. The symptoms of acutecoronary syndrome in eldery were presented in atypical feature frequently. We studied the relation of the first symptom and diagnosis of acutecoronary syndrome and distribution of risk factor and coronary angiographic finding in elderly patient of korea society. METHODS: The subjects who were under went coronary angiography between 2002.5 and 2003.8 were dividedunder 65 years old group and over 65 years old group. And each group described diagnosis, risk factor, first symptom and coronary angiographic finding retrospectively. RESULTS: The diagnosis of unstable angina are more higher(46.5% vs. 26.1%, p<0.01) in the over 65 years old group and the first significant symptom of typical chest pain was more higher(57.4% vs. 47.6%, p<0.01) in the under 65 years old group and dyspnea was more higher(22.8% vs. 9.2%, p<0.01) in the over 65 years old group. The number of abnormal vessel were more higher(66.3% vs. 46.9%, p<0.01) in the over 65 years old group. CONCLUSION: Over 65 years old group compared with younger age group were prewented more frequently angina equivalent symptom than typical chest pain. And at the diagnosis of Acute Coronary Syndrome, over 65 years old group showed more severe coronary angiographic finding. Consequently, early stage of diagnostic approach and treatment need scrupulous attention in the elderly patients.
Acute Coronary Syndrome* ; Aged* ; Aging ; Angina, Unstable ; Chest Pain ; Coronary Angiography ; Diagnosis* ; Dyspnea ; Humans ; Korea* ; Retrospective Studies ; Risk Factors

BACKGROUND: Metabolic syndrome, a concurrence of disturbed glucose and insulin metabolism, over- weight and abdominal fat distribution, dyslipidemia and hypertension, is associated with subsequent de- velopment of type 2 diabetes mellitus and cardiovascular disease, especially coronary heart disease. The aim of the study is to assess the relationship between metabolic syndrome and coronary heart disease in elderly greater than 65 years old. METHODS: Eighty two elderly patients greater than 65 years old who underwent coronary angiography were divided into two groups with metabolic syndrome or without metabolic syndrome, and assessed the association with coronary angiographic finding. The metabolic syndrome factors and cardiovascular risk factors of JNC 7 were investigated to assess the relationship with coronary heart disease in elderly. Coronary heart disease was defined as 50% or greater diameter in stenosis of coronary artery in coronary angiography. RESULTS: In elderly patients with metabolic syndrome, coronary angiographically abnormal findings(p<0.05) and multi vessel disease findings(p<0.05) were presented significantly higher than non metabolic syndrome patients. In elderly patients with 3 and more cardiovascular risk factors of JNC 7, coronary angiographically abnormal findings(p<0.05) and multi vessel disease findings(p=0.059) were presented more than the other patients. Diabetes mellitus was related significantly with coronary heart disease(p value 0.044). CONCLUSION: In elderly patients, metabolic syndrome was significantly related with coronary heart disease and diabetes mellitus had strong relationship with coronary heart disease. Metabolic syndrome and cardiovascular risk factors of JNC 7 should be further evaluated to assess the relationship with coronary heart disease in the future.
Abdominal Fat ; Aged* ; Cardiovascular Diseases ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease* ; Coronary Vessels ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Glucose ; Heart ; Humans ; Hypertension ; Insulin ; Metabolism ; Risk Factors

A 51-year old woman was admitted to our hospital because of Exertional dyspnea, Palpitation, Headache, upper-limb hypertension, and lower-limb claudication. A loud systolic bruit was audible along Lt. carotid artery. Upper limb hypertension was responsed to drug moderately (included ACEI, alpha, beta-blocker, Ca++-channel blocker), but claudication of lower limb was aggravated, also on exertion, Blood Pressure of upper-limb was elevated to 180 mmHg. So, chest CT and Aortogram was performed, we confirmed long segmental stenosis from thorasic Aorta to the renal a. bifurcation level. Finally, We performed after axillo-femoral bypass surgery. After surgery, upper limb hypertension and lower limb claudication was improved.
Aorta ; Blood Pressure ; Carotid Arteries ; Constriction, Pathologic ; Dyspnea ; Female ; Headache ; Humans ; Hypertension ; Lower Extremity ; Middle Aged ; Takayasu Arteritis ; Tomography, X-Ray Computed ; Upper Extremity